神农本草经论知母下水的本草溯源及证药浅析
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摘要
通过对《神农本草经》中知母"肢体浮肿,下水"进行古代文献学习和查阅,对知母进行本草溯源,认为其通过除邪气,清肺热,通利水道,滋肾阴,其性寒滑质润,滑利关门(膀胱),则小便通,而主"肢体浮肿,下水"。应用始建于《金匮要略》桂枝芍药知母汤治疗以其除邪气而治疗湿痹导致脚肿如脱,李东垣创立滋肾丸治疗水肿,小便隆闭。经后世广为运用,叶天士曾在《临证指南医案》中6次提及滋肾丸的运用,陈修园在其论著水肿一章中根据桂枝芍药知母汤,滋肾丸使用知母的经验,创立治水第一方消水圣愈汤。
The article reviews ancient literature of the common e ect of Zhimu(common anemarrhena rhizome) on removing edema in the extremities and promoting urination rstly recorded in Shen Nong Bencao Jing and with organizing knowledge on traditional Chinese materiamedica, we found it could eliminate evil gas, clear lung heat, dredge water channel, nourish kidney yin and is cold and smooth in nature, inducing diuresis. Guizhi Shaoyao Zhimu Decoction was rstly recorded in Synopsis of the Jingui Yaolüe treating swollen legs and numbness in damp arthralgia. Zishen Pill was created by Li Dongyuan to relieve edema and dysuria, so broadly used by later TCM doctors that it was 6 times introduced in Linzheng Zhinan Yi'an and Chen Xiuyuan created the most famous decotion to treat edema——Xiaoshuin Shengyu Decoction in a chapter concerning edema therapy of his treatise according to his experience of the application of Zhimu in Guizhi Shaoyao Zhimu Decoction and Zishen Pill.
The article reviews ancient literature of the common e ect of Zhimu(common anemarrhena rhizome) on removing edema in the extremities and promoting urination rstly recorded in Shen Nong Bencao Jing and with organizing knowledge on traditional Chinese materiamedica, we found it could eliminate evil gas, clear lung heat, dredge water channel, nourish kidney yin and is cold and smooth in nature, inducing diuresis. Guizhi Shaoyao Zhimu Decoction was rstly recorded in Synopsis of the Jingui Yaolüe treating swollen legs and numbness in damp arthralgia. Zishen Pill was created by Li Dongyuan to relieve edema and dysuria, so broadly used by later TCM doctors that it was 6 times introduced in Linzheng Zhinan Yi'an and Chen Xiuyuan created the most famous decotion to treat edema——Xiaoshuin Shengyu Decoction in a chapter concerning edema therapy of his treatise according to his experience of the application of Zhimu in Guizhi Shaoyao Zhimu Decoction and Zishen Pill.
引文
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[2]张仲景.金匮要略[M].何任,何若苹,整理.北京:人民卫生出版社, 2003:29.
[3]乔洪华.桂枝芍药知母汤应用举隅[J].安徽中医学院学报,1999(1):39-40.
[4]刘梓衡.临床经验回忆录[M].成都:四川人民出版社,1980:9.
[5]吴建红.简述桂枝芍药知母汤的源流发展[J].湖北中医学院学报, 2000(3):14.
[6]卢之颐.本草乘雅半偈[M].北京:人民卫生出版社, 1986:319.
[7]孙思邈.备急千金要方[M].吴少祯,焦振廉,校.北京:中国医药科技出版社, 2011:418.
[8]李恩庆.《千金要方》中治疗水气病的组方用药规律[J].陕西中医, 2005(12):1375.
[9]杜文夑,焦耿芳.药鉴[M].上海:上海人民出版社,1975:88.
[10]王焘.外台秘要[M].吴少祯,王淑民,校.北京:中国医药科技出版社, 2011:365.
[11]邹澍.本经疏证[M].上海:上海卫生出版社, 1957:168.
[12]李东垣.兰室秘藏[M].北京:中国医药科技出版社,2018:86.
[13]李东垣.东垣试效方[M].北京:中国医药科技出版社,2018:140.
[14]黄宫绣.本经疏证[M].北京:中国中医药出版社,2010:85.
[15]李用粹.证治汇补[M].北京:中国中医药出版社,2010:78.
[16]叶天士.本草经解[M].北京:学苑出版社, 2011:56.
[17]叶天士.临证指南医案[M].北京:人民卫生出版社,2006:119.
[18]陈修园.陈修园医学全书[M].西安:陕西科学技术出版社,2011:887.
[19]颜东明.略谈知母的利尿作用[J].陕西中医, 1995(5):231.
[20]丁仁甫.滋肾丸临床应用[J].中成药研究, 1983(5):45.
[21]陈学勤.通关滋肾丸加琥珀治小便癃闭[J].中成药研究,1980(2):52.
[22]吕建卫,伍小红,郭军,等.知母汤合升麻牛蒡元参汤临床应用[J].陕西中医, 2008(6):738.
[23]何耀荣,廖飞飞.消水圣愈汤治验举隅[J].新中医,1987(11):45.
[24]梅占武,宋敦成.加味消水圣愈汤治验2则[J].吉林中医药, 1992, 17(6):28.
[25]王道义.消水圣愈汤的临床应用[J].中医杂志, 1982(8):42-43.
[26]缪希雍.本草经疏[M].吴少祯,李玉清,校.北京:中国医药科技出版社, 2011:128.
[27]胡剑萍.桂枝芍药知母汤治疗糖尿病周围神经病变的临床观察[D].广州:广州中医药大学, 2012.
[28]张志聪.本草崇原[M].北京:中国中医药出版社, 2008:82.